1998-0915_HARDY & HARPER, INC._Insurance Certificate CERTIFICA : OF LIABILITY INSUF \10ECSR ES DATE(MM/DDYI)
HARDY-1 09/15/98
PRODUCER. - THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Malan Insurance Brokers, LLC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
CA License #0003916 HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
25 Mauchly, Suite 327 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Irvine CA 92618 COMPANIES AFFORDING COVERAGE
Eric Schroeder COMPANY
PnoneNo. 949-450-8500 FaxNo 949-450-8505 A Pacific Insurance Company, Ltd
INSURED COMPANY
B RLI Insurance Company
COMPANY
Hardy & Harper, Inc. C Golden Eagle Insurance Corp.
1312 E. Warner Avenue COMPANY
Santa Ana CA 92705 D Ulico Casualty Company
COVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO POLICY EFFECTIVE POLICY EXPIRATION
TYPE OF INSURANCE POLICY NUMBER LIMITS
LTR DATE(MM/DD/YY) DATE(MM/DD/YY)
GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000
A X COMMERCIAL GENERAL LIABILITY ZI0007342 07/01/98 07/01/99 PRODUCTS-COMP/OPAGG $ 1,000,000
CLAIMS MADE X OCCUR PERSONAL&ADV INJURY $ 1,000,000
OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE S1,000,000
X Per Project Agg. FIRE DAMAGE(Any one fire) $ 50,000
MED EXP(Any one person) $ 2,500
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $ 1,000,000
C X ANY AUTO CCP-571246-00 07/01/98 07/01/99
ALL OWNED AUTOS
BODILY INJURY $
SCHEDULED AUTOS (Per person)
HIRED AUTOS
BODILY INJURY $
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN AUTO ONLY:
EACH ACCIDENT $
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $ 5,000,000
B X UMBRELLA FORM OUL0027821 07/01/98 07/01/99 AGGREGATE $ 5,000,000
OTHER THAN UMBRELLA FORM $
WORKERS COMPENSATION AND X WC STATU- 0TH-
EMPLOYERS'LIABILITY TORY LIMITS I ER
EL EACH ACCIDENT $ 1,000,000
D THE PROPRIETOR/ INCL CF704070400 07/01/98 ' 01/01/99 EL DISEASE-POLICY LIMIT $ 1,000,000
PARTNERS/EXECUTIVE
OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 1,000,000
OTHER
E Great American Ins 11 MAC9024200-01 07/01/98 , 07/01/99 per item $50,000
Rented/Leased Equi per occur $100,000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
The City of San Juan Capistrano and its elected and appointed officials are
named as additional insured per the attached CG2010 endorsement. Primary
wording is included. H&H Job No. 5011L
CERTIFICATE HOLDER CANCELLATION
SNJUAN1 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
City of San Juan Capistrano BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
32 400 Paseo Adelanto OF ANY KIND UPON THE COMPANY,ITS AGENTS OR "E,SE 1TIVES
San Juan Capistrano CA 92675 AUTHORIZED REPRESENTATIVE
•
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Eric Schroeder
Z,
ACORD 25-S(1/95) . / " ACORs'CORPO ATI . N 1988
PO,I ICIINUMBER: Z10007342 COMME,.—.. L GENERAL LIABILITY
EFFECTIVE: 07/01/98 to 07/01/99
THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY
ADDITIONAL INSURED - OWNERS, LESSEES OR
CONTRACTORS (FORM B)
This endorsement modifies insurance provided under the following:
COMMERCIAL GENERAL LIABILITY COVERAGE PART.
SCHEDULE
Name of Person or Organization:
The City of San Juan Capistrano and its elected and appointed officials
(If no entry appears above, information required to complete this endorsement will be shown in
the Declarations as applicable to this endorsement.)
WHO IS AN INSURED (Section II) is amended to include as an insured the person or
organization shown in the Schedule, but only with respect to liability arising out of your ongoing
operations performed for that insured.
It is agreed that such insurance afforded by the policy for the Additional Insured shown above
shall be Primary Insurance, but only as respects any claims, loss or liability arising out of the
Named Insured's operation on this project and any insurance maintained by the Additional
Insured shall be non-contributory.
Named Insured: Hardy and Harper, Inc.
Effective: 07/01/98 to 07/01/99
Mahan Insurance Brokers, LLC
CA License #0003916
25 Mauchly, Suite 327
Irvine, CA 92618
CG 20 10 10 93 Copyright, Insurance Services Office, Inc., 1992